SOUTHSIDE MEDICAL CLINIC AT THE ADLER CENTER (NPI# 1700121084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700121084 |
| Entity Type | Organization |
| Organization Name | SOUTHSIDE MEDICAL CLINIC AT THE ADLER CENTER |
| Practice Address |
416 E Hennepin Ave Minneapolis MN 55414-1006 |
| Mailing Address |
4243 4th Ave S Minneapolis MN 55409-2113 |
| Practice Telephone | 6128229030 |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2014-04-30 |
| Authorized Official Name | MR. WILLIAM HENRY TENDLE JR. (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6128212800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
416 E HENNEPIN AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55414-1006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104038215 | Center for Mindful Dialogue, Pa | Psychologist | 416 E Hennepin Ave, Suite 107, Minneapolis, MN 55414-1006 | 2007-05-03 |
| 1003075938 | Tina Mcrae | Specialist | 416 E Hennepin Ave, Suite 202, Minneapolis, MN 55414-1006 | 2008-06-05 |
| 1497925911 | Martha Susan Cohen | Psychologist | 416 E Hennepin Ave, Ste 107, Minneapolis, MN 55414-1006 | 2008-03-12 |
| 1598955288 | 21st Century Care of Minnesota LLC | Home Health | 416 E Hennepin Ave, Suite 105, Minneapolis, MN 55414-1006 | 2007-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407496516 | Liza N Meredith | Psychologist | Acacia Counseling and Wellness, 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2020-01-07 |
| 1346888732 | Danielle Lee Ann Vogler-bos | Naturopath | 575 Se 9th St, Suite #52, Minneapolis, MN 55414 | 2019-12-16 |
| 1164071148 | Amy C Moran | Psychologist | Acacia Counseling & Wellness, 2724 University Ave., Unit B, Minneapolis, MN 55414 | 2019-09-11 |
| 1346806585 | Kristen Bastug | Student in an Organized Health Care Education/Training Program | General Pediatrics and Adolescent Health, 1932k, 1717 Delaware Street Southeast, Suite 353, Minneapolis, MN 55414 | 2019-05-14 |
| 1053881698 | Lauren Michelle Scholder | Psychologist | 401 Main St Se Apt 7009, Minneapolis, MN 55414 | 2018-11-27 |
| 1427530666 | Kelli Howard | Psychologist | 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2018-09-04 |
| 1306370218 | Jiexiong Yang | Student in an Organized Health Care Education/Training Program | 814 Essex St Se, Minneapolis, MN 55414 | 2017-04-18 |
| 1598297699 | Patrick Curran | Student in an Organized Health Care Education/Training Program | 628 University Ave Se, Apt. 112, Minneapolis, MN 55414 | 2017-03-29 |
| 1679923957 | Jillian Theresa Tholen | Dietitian, Registered | 411 E Hennepin Ave, Minneapolis, MN 55414 | 2016-06-16 |
| 1073960290 | First Language Interpreter & Translation Services LLC | Interpreter | 2828 University Ave Se Suite 150, Minneapolis, MN 55414 | 2016-05-17 |
| Find all providers in zip 55414 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336594498 | Jaimi Weber | Family Medicine | Mmc 381, 420 Delaware St. Se, Minneapolis, MN 55445 | 2016-04-26 |
| 1376906388 | Sama Healthcare | Family Medicine | 2639 Nicollet Ave., Suite 130, Minneapolis, MN 55408 | 2016-03-29 |
| 1902209687 | Elaine May | Family Medicine | 2861 Burnham Blvd, Minneapolis, MN 55416-4331 | 2014-10-08 |
| 1952741050 | Gregory Olszewski | Family Medicine | 19 S 1st St Apt B2603, Minneapolis, MN 55401-1845 | 2013-07-03 |
| 1881940864 | Isaac Milton Engholm | Family Medicine | 825 Nicollet Mall Ste 403, Minneapolis, MN 55402-2611 | 2012-07-27 |
| 1942572763 | Neighborhood Healthsource | Family Medicine | 1015 4th Avenue North, Suite 201, Minneapolis, MN 55405-1178 | 2012-02-09 |
| 1225323371 | Yun Chau Bernice Lee | Family Medicine | 2823 Dean Pkwy, Minneapolis, MN 55416-4401 | 2011-06-16 |
| 1730487208 | Specialized Medical Response, LLC | Family Medicine | 401 Harding St Ne #100, Minneapolis, MN 55413 | 2011-03-08 |
| 1285930065 | Allina Health System | Family Medicine | 3024 Snelling Ave S, Minneapolis, MN 55406-1911 | 2011-01-27 |
| 1013226844 | Corban Health Care, Pllc | Family Medicine | 5141 36th Ave S, Minneapolis, MN 55417-1518 | 2010-09-28 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55414 |
Please comment or provide details below to improve the information on SOUTHSIDE MEDICAL CLINIC AT THE ADLER CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.